South Carolina attorneys look inward to address high rates of substance abuse and mental illness

Law and Disorders

She had been late or completely absent from hearings for months. Several times her clients would find themselves standing before a judge, knowing only that their hired attorney had vanished. And that was only on the occasions when the Greenville lawyer had managed to inform her clients of a scheduled court date. On a person-to-person level, it was clear that something wasn't right. But it would take time before the right people realized just how pervasive the problem was.

Before the Greenville attorney's missteps caught the attention of a family court judge in 2016, which led to her eventually being disbarred in the fall of 2016, her former employees had already grown well aware that their boss wasn't always so reliable.

Appearing before a judge on May 6, 2013, the attorney's client and former legal assistant found herself tasked with explaining why she was left to stand on her own to settle a child custody matter that day. Client B, as she is described in documents from the South Carolina Supreme Court, explained that her attorney had ceased communicating with clients and stopped coming into the office. This, of course, posed an incredible burden to those who looked to the attorney to guide them through the cryptic, arcane world of the courtroom. But this had not always been the case.

What is the Office of Disciplinary Counsel?

Tasked by the state Supreme Court with assessing and investigating judges and attorneys, the Office of Disciplinary Counsel resolved 1,586 complaints against attorneys between July 1, 2017, and June 30, 2018.

These investigations resulted in 92 letters of caution, 14 public reprimands, 15 suspensions, and eight disbarments.

Since the ODC began reporting annual data on complaints related to substance abuse or mental health in 2013, 191 cases have involved disciplinary action related to substance abuse or an attorney being unable to fulfill their duties due to mental illness.

In an affidavit filed with the Office of Disciplinary Counsel (ODC), another legal assistant praised her former boss' attitude when they first began working together in October 2011.

Unfortunately, that would all change over the coming months. Tracking down her boss became a daily challenge. The assistant was forced to field constant calls from irate clients, clerks, and judges curious as to the attorney's whereabouts. At least one other assistant would describe similar behavior lasting into 2013 when the Greenville attorney was eventually suspended from practicing law.

In the months leading up to that May 6 family court hearing which led to an official complaint from the judge, the lawyer's final few clients faced the added challenge of an absentee attorney on top of their already mounting legal troubles.

After paying $3,000 in January 2013 to retain counsel, a man facing a DUI charge went months without hearing from the Greenville attorney. One client, a mother looking to settle a divorce and child custody issues with her soon-to-be ex-husband, learned via text message that the attorney had failed to file the necessary paperwork. Another client called the attorney's office only to find the phones had been disconnected. After two-and-half years on the case, the mother eventually learned that her divorce had yet to be finalized. Years later, in a ruling from the state Supreme Court, the cause behind this attorney's chronic failures would become a matter of public record.

"According to respondent, the matters described in this opinion occurred during a time when she was using prescription drugs and alcohol to cope with stress and depression," wrote the Supreme Court justices. Sadly, this case is not an aberration.

Exempli gratia

In February 2016, a Charleston attorney found herself temporarily suspended for three months after allowing a burn victim's case against his insurance company to lapse past the statute of limitations. During her time on the case, the attorney suffered complications from multiple surgeries to her back and shoulder. According to legal records, she began taking narcotics and muscle relaxers to manage the pain and spasms. During this same period, she was also being treated for depression and anxiety due to her deteriorating physical condition. Still, the law yields to no one. The wheels of justice roll on.

The following month, a retired Elgin attorney and recovering addict was publicly reprimanded by the state Supreme Court. Twenty years after he quit practicing law and following a stint in prison, the 70-year-old was contacted by an recent acquaintance from drug court asking for legal assistance for a child who was facing trial. After failing to reach the kid's public defender, the former attorney spoke to a judge on the juvenile's behalf, despite the man's license to practice law being suspended at the time. From reviewing the records, it seems to have started, as with many mistakes, with the best of intentions.

The former attorney's disciplinary hearing revealed that following the dissolution of his marriage, alcohol and drug abuse resulted in the loss of his home, numerous stints in rehab, and multiple arrests. Despite his disciplinary troubles at the time, he claimed to have been maintaining his sobriety with the support of a volunteer with the Lawyers Helping Lawyers program and daily 12-step meetings.

This individual, looking back on a lengthy legal career, told the court he had no plans to return to practice. It was a world of which he had gotten his fill, or perhaps one that he merely inhabited for a time before it left him behind. For the most part, his story is over. At least as far as the law is concerned. But what of those still early in their careers facing the same struggles?

There is a recurring cycle in the American legal system. Those marked with an unfortunate mix of ambition, cleverness, and pathos are ground down. Time after time, they find themselves standing before a judge. It becomes uniform. Until the last time. Until the balance of law and order becomes too much to maintain. But this isn't a story about those who step into a courtroom as defendants or to seek justice for themselves, although they also pay a price. This is about those who dedicate their lives to the law, only to find their attention and will stolen away by addiction and illness. Fortunately, there are a growing number of people in Charleston — and throughout South Carolina — who are willing to help.

Friend of the Court

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Robert Turnbull

It's been 16 years since attorney Robert Turnbull accepted his role in charge of the South Carolina Bar Association's substance abuse and mental health support program, now known as Lawyers Helping Lawyers. Until that point, the program had been led by a committee of volunteers, which Turnbull says hadn't met for a couple of years. With a rare mix of modesty and frankness, Turnbull jokes that he didn't really race to fill the position when it first became available.

"I forgot to look over my shoulder and turn into a pillar of salt," he says with a short chuckle.

After assembling a task force and examining how bar associations in other states addressed substance abuse in the legal profession, Turnbull became the full-time director of the Lawyers Helping Lawyers program, which assists in connecting struggling attorneys with the best methods of treatment and volunteers experienced in recovery. Turnbull is joined by his co-director Beth Padgett, who he describes as a godsend for South Carolina's legal community — someone who fully cares about a group that tends not to put too much care into themselves.

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Beth Padgett

"People who have these disorders aren't really good at reaching out. And lawyers are really bad at asking for help," says Padgett. "If you have depression or substance abuse disorder, the phone feels like it weighs 500 pounds. It's almost impossible sometimes to pick up and make the call. Having volunteers in the community, they help us keep the person in contact."

Padgett likens the group's volunteers to the sponsors one might find in Alcoholics Anonymous. They operate as a friend with experience who can offer hope and structure to a lawyer who is struggling. In many cases, the volunteers perform a vital service to those suffering and offer a way back onto the right path.

"Early in my recovery, it was suggested that I contact my sponsor daily," says Turnbull. "And if I didn't contact my sponsor, my sponsor was back on me pretty quick to find out what was going on. It's just kind of another level of involvement with a little piece of accountability that helps in the long run."

Anyone doubting Turnbull's firm conviction in the power of rehabilitation can look to the case of Mark Evans.

In 1996, Evans pleaded guilty to a felony offense following the hit-and-run death of Laura Griffin, director of the College of Charleston's substance abuse prevention program. On Jan. 17 of that year, while jogging along the Battery, Griffin was struck by Evans' vehicle after he drove over a curb. He had been drinking that evening. Three days after the crash, Evans turned himself in. Two days later, Griffin succumbed to her injuries. Evans would become one of only three lawyers since 1821 who had been disbarred due to a conviction for a crime involving the death of a person, according to Office of Disciplinary Counsel testimony. His crime was tragic. His reinstatement as an attorney was unfathomable.

Following his guilty plea, Evans served more than seven years in prison, during which time he completed a drug and alcohol program. After his release, Evans worked in his sister's restaurant in Charleston and did construction work. He once again passed the state bar exam. Evans had been heavily involved in local Alcoholics Anonymous programs, as well as Lawyers Helping Lawyers' monitoring program when he eventually made an unlikely bid to regain his legal license in 2007. After an initial denial and opposition from the Office of Disciplinary Counsel, Evans appealed the decision and his case went before the state Supreme Court in October 2008.

According to a Supreme Court decision, Evans had exchanged letters with his victim's mother during his time in prison. Over the years, he earned her support for returning to the legal profession. But that level of forgiveness does not absolve someone of their crimes in the eyes of the state's highest court. Evans would need someone by his side as he made a final appeal.

In addition to Evans' Alcoholics Anonymous sponsor, he found a vocal advocate in Turnbull, who supported Evans' reinstatement. In their final decision, the state justices wrote that Turnbull "feels confident, given the safeguards that can be put into place through Lawyers Helping Lawyers, that if [Evans] is readmitted, he will be a better lawyer than he was before his suspension and disbarment."

By order of the state Supreme Court, Evans was formally reinstated as an attorney on Nov. 6, 2008. Although much can be taken away from Evans' story, it clearly demonstrates Turnbull's dedication to the Lawyers Helping Lawyers program and the possibility of redemption.

Bona Fide

As is to be expected with attorneys, confidentiality is key.

Members of the South Carolina Bar Association can contact Lawyers Helping Lawyers through a completely confidential hotline. Attorneys can also access five free counseling sessions each year. According to Padgett, it's becoming more common for attorneys struggling with addiction or mental illness to pick up the phone, but often the program is also contacted by judges, family members, or colleagues of lawyers unwilling to admit that they have a problem. And research shows that within the legal profession, it's practically impossible that you won't cross paths with someone in dire need of help.

A 2016 study conducted in part by the Hazelden Betty Ford Foundation (PDF) surveyed almost 13,000 attorneys across the nation to determine rates of alcohol and drug use, as well as depression and anxiety. The findings went on to reshape perceptions within the legal field and provide empirical support for those looking to address the problems affecting the profession.

Of the 12,825 working attorneys surveyed, more than 20 percent showed signs of harmful and potentially alcohol-dependent drinking, especially among men and younger attorneys. Among those experiencing problematic drinking, almost 44 percent reported that these issues arose within 15 years of completing law school.

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Dr. Suzanne Thomas

Dr. Suzanne Thomas, professor at MUSC's Department of Psychiatry Addiction Sciences Division, regularly lectures legal professionals on the risks of addiction in their field. Thomas says the fact that many social and professional functions center around alcohol poses a risk — similar to what has been experienced by Charleston's food and bev industry.

"Drinking in that population is pretty normative," Thomas says of those in the legal profession. "When everybody else around you is doing it, it doesn't feel like you are out of the norm. A lot of deals and conversations about the issues that they are solving are made over drinks. It's an occupational hazard, I guess you could say."

This casual brand of drinking becomes a problem when it develops into a coping method for stress or depression. As Thomas explains, if you are drinking to manage stress, you aren't learning to cope through other, healthier means. This is especially important among younger drinkers, who may limit or completely halt their ability to develop healthy coping methods as they grow older.

"Even if two people are drinking the same amount, and one person is drinking to relieve stress and the other is drinking just to have fun, the person who drinks to relieve stress is at a much higher risk of going on to develop alcoholism in the future," says Thomas.

De Futuro

When attorney Mike Ethridge moved to Charleston and opened his own firm in February of 2017, he wanted to create a different kind of office environment than one might find at larger, more traditional firms.

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Mike Ethridge

With six lawyers now at what is described as a "thriving little practice," he didn't want Ethridge Law Group to be an office where not sleeping is worn like a badge of honor and addiction to work is held up as a virtue. According to Ethridge, the high rate of problem drinking among attorneys isn't solely due to the socializing among attorneys revolving around alcohol. It comes down to the inherent nature of the business.

"It's the never-let-them-see-you-sweat culture. One of the things that a young lawyer is told as soon as they start practicing law is 'No matter how scared or frightened you are, don't ever show any sign of weakness to the other side,'" says Ethridge. "You've got to stand on your own two feet. You can't rely on anybody else. It's a very aggressive culture."

Ethridge isn't trying to pass any judgment when he says the nature of our legal system is adversarial. It's built into our very nature. That's how we arrive at justice. That's how we find the truth. Two sides stand before a judge and present their arguments. An attorney, wanting to comfort their client while simultaneously gaining the trust of the jury, must not appear too vulnerable, too unsure. They wear confidence and certainty as a necessary protective layer, but sometimes this creates a shell that becomes too much to escape.

"It becomes who they are. So when they get home, it's much more important to win the argument with their spouse than it is to try to understand what he or she is talking about and find some real place of connection over a point of disagreement," says Ethridge. "That permeates every relationship in their lives. Then what happens is lawyers become more and more isolated, and they are most comfortable sitting and talking to other lawyers about their cases and litigation, and are less engaged with the outside world. That compounds an already difficult problem."

There are some aspects of the legal profession that Ethridge knows can't be changed. The work will always be a bit combative by nature. Firms will still manage their workload by billable hours. For many attorneys burdened by tracking and accounting for every six minutes of each hour, the push of competition and pressure from those upstairs can compel them to keep long hours. But Ethridge hopes that he can at least improve the working conditions of those who toil alongside him.

"We want to create a law firm where there is a culture and an environment where a priority and core value of the firm is to care for those who are working at the firm," he says. "I think the net result of that is if you create a law firm that is committed to taking good care of those who work there and supporting them on their work, developing professionally, and taking care of themselves, their health and well-being, you end up with a firm capable of doing really good legal work."

The South Carolina Bar Association's own Attorney Wellness Committee, of which Ethridge is a member, has proposed a rule change to the state Supreme Court that would allow attorneys to take time off without first receiving a formal order from a judge. Across the state, more local bar associations are creating their own wellness committees to assist those within their own communities. For Ethridge and others working to improve working conditions among their profession, it's this level of cooperation that will lead to lasting change.

"We love this profession. We are really committed to it. But to do it as it needs to be done and as the world needs it to be done, we need to bring the best versions of ourselves to that. We can't do that if we aren't taking care of ourselves and making that a priority," says Ethridge. "We also can't do it if we are out there, beaten up and going to war with everybody else. Lawyers need to support each other in taking care of themselves. The whole system is just going to work better for everybody when that happens."

Inter Se

Among those newly established wellness committees is the one founded by the Charleston County Bar last year. Chaired by Mt. Pleasant attorney Marie-Louise Ramsdale of Ramsdale Family Law, the mental health organization springs from the attorney's own experience with loss.

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Marie-Louise Ramsdale

"I had the idea for this group because I have lost several friends who are attorneys as a result of various mental health issues. I was also aware of the loss of attorneys across the state and nation due to mental health issues," says Ramsdale. "I would say that most of us who are attorneys have been touched in some way, if not personally, by mental health issues of a friend attorney or a colleague attorney. I think that's more than accurate due to the prevalence of the challenges of this profession."

Aside from high rates of drinking, the Hazelden study also found significant levels of mental health problems among attorneys. Researchers reported 28 percent of lawyers who completed the necessary survey suffered symptoms of depression, with 19 percent experiencing anxiety. Almost 12 percent of participants reported suicidal thoughts at some point during their legal career. Three percent of attorneys surveyed reported inflicting some form of self-harm, and nearly one out of every 100 attorneys had attempted suicide.

"I think we're coming to recognize — especially after the Hazelden study about two-and-a-half years ago with attorneys across the nation — that mental health issues in the legal profession are much more pervasive than what we thought they were before," says Robert Turnbull with Lawyers Helping Lawyers. "Particularly with anxiety, stress, and depression. Suicide is still a huge factor in the legal profession."

Although many in the legal profession are well aware of colleagues who have taken their own lives, the stigma surrounding mental illness and the fear of harming one's career causes many to suffer in silence.

According to Ramsdale, the number of local attorney suicides in the past five years has awoken many to the threat of mental illness in the profession, yet the deaths continue to come more and more frequently.

"I think the legal profession as a whole is becoming more understanding, but you have to balance that with protecting clients' interests, which is first and foremost in the minds of the governing bodies of the bar," she says. "I think that itself can create sort of a Catch 22. 'Well, if I get help, then am I setting myself up for malpractice or professional discipline or something like that?' That is something that is troubling for lawyers who may be considering getting help. 'Who's going to see me? Who is going to know about it? Who is going to talk about it?'"

This year, the South Carolina Bar Association's Lawyers Helping Lawyers program received funding approval to train 100 attorneys across the state in mental health first aid training. This means participants will gain a better understanding of intervention methods and the warning signs of mental illness and substance abuse. Co-director Beth Padgett stresses the confidentiality of those who seek help through the program and hopes that the increased awareness brought about by the newly funded training effort will reduce the stigma surrounding mental health and addiction in the industry.

Who to call

Those who feel they may be suffering from addiction or mental illness and want to get help can call the Lawyers Helping Lawyers free helpline at 866-545-9590. Bar members can also access up to five free hours of intervention counseling by calling 855-321-4384 to be put in touch with a counselor in their area.

Attorneys in the Charleston area in need of confidential help can also email Marie-Louise Ramsdale at ml@ramsdalelaw.com.

The greatest barrier to seeking help, according to the Hazelden study? Fear of others finding out that they needed help. Put simply, attorneys are safeguarding careers and reputations ahead of their own survival. In this case, those tasked with carrying out the various functions of our legal system had placed the system before their own well-being. For these individuals, pride and professionalism was enough to ignore the fact that they needed and deserved help. With the knowledge of all those across the state who are suffering in silence, Padgett has one final plea.

"It can get better. You can recover. Your work can be better. Your life can be better. Don't wait," she says. "The minute you know something is wrong, it's time to call. Because the longer you wait, the harder it gets to heal."

Although the Charleston County Bar Association's own mental health wellness committee is still in its early days, having recently held their second meeting with other monthly meetings scheduled throughout the year, the group has received an overwhelming response from the local legal community looking to participate. Aside from spreading awareness about resources such as Lawyers Helping Lawyers, the committee is planning to organize first-responder mental health training for its members starting early next year. In the meantime, county chairperson Maria-Louise Ramsdale offers her own spare time and attention to helping those across the Lowcountry who may be in trouble. She insists she's just a call away.

"If you are suffering, please ask for help. You don't have to be alone. Anybody can call me. I will take their calls and I will help them," says Ramsdale. " 'You're not alone' is the message we want to put out there. We'll do whatever we need to get you whatever help you need. That's what we're trying to convey. The law can be a lonely master or mistress."